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Uric acid plasma levels are associated with C-reactive protein concentrations and the extent of coronary artery lesions in patients with acute coronary syndromes

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Abstract

Many studies have pointed out that inflammation plays a pivotal role in pathophysiology of acute coronary syndromes (ACS) because several inflammatory molecules impair the endothelial functions in the coronary circulation and promote atherothrombotic events. Recently, many clinical/experimental evidences indicate that elevated plasma levels of uric acid (UA) might be considered a risk factor for developing ACS. It has been reported that elevated UA doses impair physiologic functions of endothelial cells, shifting them toward a pro atherothrombotic phenotype. In the present manuscript, we investigated the relationship between UA plasma levels, inflammatory burden, and extension of coronary atherosclerotic disease in patients with ACS. Patients with a clinical presentation of ACS (ST-elevated and non-ST-elevated myocardial infarction) admitted to the Vanvitelli Catheterization Laboratory at Monaldi Hospital in 2019, before the COVID-19 pandemia, were retrospectively analyzed. Biochemical profile, type of ACS presentation, as well as extension of coronary atherosclerosis were assessed. A total of 132 ACS patients were included in the analysis, and grouped into 3 tertiles according to the UA values (UA < 4.72 mg/dl, UA between 4.72 and 6.15 mg/dl, and UA > 6.15 mg/dl). Patients with UA plasma levels ≥ 6.15 mg/dL showed higher levels of C-reactive protein (mean of 5.1 mg/dL) as compared to patients with lower UA plasma levels. Moreover, the former group of patients showed higher levels of cardiac troponin and CPK, and presented more often with multivessel disease and complex coronary stenosis (type C of Ellis classification). Even though monocentric and with limited sample size, the present study shows that plasma levels of UA and hs-CRP are elevated in ACS patients and are associated with a more severe coronary disease, suggesting a potential role of UA in the pathophysiology of acute coronary events.

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Funding

This research was funded by V:ALERE program 2019—OMICs-ACS, from University of Campania Luigi Vanvitelli.

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Authors and Affiliations

  1. Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, Naples, Italy

    Giovanni Cimmino & Paolo Golino

  2. Cardiology Department, IRCCS Galeazzi-Sant’Ambrogio Hospital, University of Milan, Milan, Italy

    Emanuele Gallinoro

  3. Department of Advanced Biomedical Sciences, Section of Cardiology, University of Naples “Federico II”, Via Pansini, 5, 80131, Naples, Italy

    Luigi di Serafino, Gennaro De Rosa & Plinio Cirillo

  4. Department of Internal Disease, Kazakh National Medical University, Almaty, Kazakhstan

    Akhmetzhan Sugraliyev

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  1. Giovanni Cimmino
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  2. Emanuele Gallinoro
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Correspondence to Plinio Cirillo.

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Cimmino, G., Gallinoro, E., di Serafino, L. et al. Uric acid plasma levels are associated with C-reactive protein concentrations and the extent of coronary artery lesions in patients with acute coronary syndromes. Intern Emerg Med 18, 1751–1757 (2023). https://doi.org/10.1007/s11739-023-03360-2

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